The impact of the COVID-19 pandemic on adolescent mental health

The impact of the COVID-19 pandemic on adolescent mental health is a widespread concern. However, to date, there is limited empirical evidence which can causally attribute changes to the pandemic. With the aim of overcoming some of the existing methodological limitations, the current study utilised a naturally occurring experiment within two ongoing school-based trials. Depressive symptoms, externalising difficulties (e.g., behaviour problems such as losing your temper or hitting out), and life satisfaction were assessed at baseline and 1-year follow-up across two groups. One group entered the study in phase 1 (2018; pre-COVID-19 group; N = 6,419) and were controls as they did not experience the COVID-19 pandemic between baseline and follow-up. The second group entered the study in phase 2 (2019; COVID-19 group; N = 5,031) and were exposed to the pandemic between baseline and follow-up, therefore providing a natural experiment. Key Findings • The COVID-19 pandemic led to increased adolescent depressive symptoms and decreased life satisfaction • If the COVID-19 pandemic had not occurred, estimates suggest that we would observe 6% fewer adolescents with high depressive symptoms which is a difference of 1.6% in prevalence (27.1% to 25.4%) • There was no overall effect of the COVID-19 pandemic on adolescent externalising difficulties • Girls’ mental health may have been more negatively impacted by the COVID 19 pandemic than boy

Patterns of Nonsocial and Social Cognitive Functioning in Adults With Autism Spectrum Disorder:A Systematic Review and Meta-analysis

Importance: Many studies have investigated impairments in cognitive domains in adults with autism spectrum disorder (ASD). Yet, to date, a comprehensive overview on the patterns of cognitive functioning is lacking. Objective: To provide an overview of nonsocial and social cognitive functioning in various domains in adults with ASD, allowing for comparison of the severity of deficits between different domains. Data Sources: A literature search performed in an academic medical setting was conducted using PubMed, PsycINFO, Embase, and Medline databases with the combination of the following free-text and Medical Subject Headings where applicable: [cogniti* OR neurocogniti* OR neuropsycholog* OR executive function* OR IQ OR intelligence quotient OR social cognition OR emotion perception OR affect perception OR emotion recognition OR attribution OR ToM OR mentalising OR mentalizing OR prosody OR social knowledge OR mind reading OR social cue OR social judgment] AND [autis* OR ASD OR Asperger OR Asperger's OR PDD OR pervasive developmental disorder]. The search was further limited to studies published between 1980 (first inclusion of autism diagnosis in the DSM-III) and July 2018. Study Selection: Studies included were published as a primary peer-reviewed research article in English, included individuals with ASD 16 years or older, and assessed at least 1 domain of neurocognitive functioning or social cognition using standard measures. Data Extraction and Synthesis: Of 9892 articles identified and screened, 75 met the inclusion criteria for the systematic review and meta-analysis. Main Outcomes and Measures: Hedges g effect sizes were computed, and random-effects models were used for all analyses. Moderators of between-study variability in effect sizes were assessed using meta-regressions. Results: The systematic review and meta-analysis included 75 studies, with a combined sample of 3361 individuals with ASD (mean [SD] age, 32.0 [9.3] years; 75.9% male) and 5344 neurotypical adults (mean [SD] age, 32.3 [9.1] years; 70.1% male). Adults with ASD showed large impairments in theory of mind (g = -1.09; 95% CI, -1.25 to -0.92; number of studies = 39) and emotion perception and processing (g = -0.80; 95% CI, -1.04 to -0.55; n = 18), followed by medium impairments in processing speed (g = -0.61; 95% CI, -0.83 to -0.38; n = 21) and verbal learning and memory (g = -0.55; 95% CI, -0.86 to -0.25; n = 12). The least altered cognitive domains were attention and vigilance (g = -0.30; 95% CI, -0.81 to 0.21; n = 5) and working memory (g = -0.23; 95% CI, -0.47 to 0.01; n = 19). Meta-regressions confirmed robustness of the results. Conclusions and Relevance: Results of this systematic review and meta-analysis suggest that adults with ASD show impairments in social cognitive domains and in specific nonsocial cognitive domains. These findings contribute to the understanding of the patterns of cognitive functioning in adults with ASD and may assist in the identification of targets for cognitive interventions

Schizotypal Traits and Neuropsychological Performance: The Role of Processing Speed

BACKGROUND: Cognitive deficits, particularly in processing speed, are widely recognized as a critical feature of schizophrenia, and are also present across schizophrenia spectrum disorders. A number of important confounders, however, such as hospitalization effects and antipsychotic medication, have been shown to affect processing speed, causing debate as to the core cognitive deficits of schizophrenia. The study of individuals who are not clinically psychotic but have schizotypal traits allows investigation of cognitive deficits associated with both positive and negative schizotypy dimensions while excluding potential confounds. METHODS: A population-based community sample of 242 healthy adult volunteers assessed using the Structured Interview of Schizotypy – Revised (SIS-R) scale, and a neuropsychological testing battery that included measures of verbal ability, visual and verbal memory, verbal fluency, working memory, executive functions and processing speed. Participants were classified in High or Low Positive Schizotypy (H-PST or L-PST), High or Low Paranoia-like traits (H-PAR or L-PAR) and High or Low Negative Schizotypy (H-NST or L-NST) groups, respectively. RESULTS: Individuals with H-PST performed significantly (p<0.05) worse than L-PST on measures of processing speed and executive functions. Processing speed deficits were also observed in individuals with H-PAR compared to L-PAR (p<0.05). There were no statistically significant differences in neuropsychological performance between H-NST and L-NST on any measure. CONCLUSIONS: In a population-based community sample, individuals with high positive schizotypal traits or paranoia-like traits show impairments in processing speed. Consistent with a dimensional view of psychosis, this supports the hypothesis that processing speed represents a core deficit of schizophrenia-like mental states

The impact of the COVID-19 pandemic on adolescent mental health:A natural experiment

Despite widespread concern about the impact of COVID-19 on adolescent mental health, there remains limited empirical evidence that can causally attribute changes to the pandemic. The current study aimed to overcome existing methodological limitations by exploiting a serendipitously occurring natural experiment within two ongoing, multi-phase cluster randomized controlled trials. Depressive symptoms (primary outcome), externalizing difficulties and life satisfaction (secondary outcomes) were assessed at baseline (phase 1 [pre-COVID-19 group]: September – October 2018, phase 2 [COVID-19 group]: September – October 2019) and 1-year follow-up (pre-COVID-19 group: January – March 2020, COVID-19 group: February – April 2021). Participants in phase 1 (N = 6419) acted as controls. In phase 2, participants (N = 5031) were exposed to the COVID-19 pandemic between the baseline and follow-up assessments providing a natural experimental design. The primary analysis used a random intercept linear multivariable regression model with phase (exposure to the COVID-19 pandemic) included as the key predictor while controlling for baseline scores and individual and school-level covariates. Depressive symptoms were higher and life satisfaction scores lower in the group exposed to the COVID-19 pandemic. Had the COVID-19 pandemic not occurred, we estimate that there would be 6% fewer adolescents with high depressive symptoms. No effect of exposure to the pandemic on externalizing difficulties was found. Exploratory analyses to examine subgroup differences in impacts suggest that the negative impact of the COVID-19 pandemic on adolescent mental health may have been greater for females than males. Given the widespread concern over rising adolescent mental health difficulties prior to the pandemic, this paper quantifies the additional impacts of the pandemic. A properly resourced, multi-level, multi-sector public health approach for improving adolescent mental health is necessary. Following in-principle acceptance, the approved Stage 1 version of this manuscript was preregistered on the OSF at https://doi.org/10.17605/OSF.IO/B25DH. This preregistration was performed prior to data analysis

The CIRCuiTS study: Implementation of Cognitive Remediation into Early Intervention Services: A randomised controlled trial

Background: Cognitive problems in people with schizophrenia predict functional recovery even with the best possible rehabilitation opportunities and optimal medication. A psychological treatment known as cognitive remediation therapy (CRT) aims to improve cognition in neuropsychiatric disorders with the ultimate goal of improving functional recovery. Studies suggest that intervening early in the course of the disorder will have the most benefit, so this study will be based in Early Intervention Services (EIS) which treat individuals in the first few years following the onset of the disorder. The overall aim is to investigate different methods of CRT. Methods: This is a multicentre, randomised, single blinded, controlled trial based in EIS in NHS Mental Health Trusts in six English research sites. Three different methods of providing CRT (intensive, group, and independent) will be compared to treatment-as-usual. We will recruit 720 service users aged between 16 and 45 over three years who have a research diagnosis of non-affective psychosis and will be at least three months from the onset of the first episode of psychosis. The primary outcome will be the degree to which participants have achieved their stated goals using the Goal Attainment Scale. Secondary outcomes will include improvements in cognitive function, social function, self-esteem and clinical symptoms. Discussion: It has already been established that cognitive remediation improves cognitive function in people with schizophrenia. Successful implementation in mental health services has the potential to change the recovery trajectory of individuals with schizophrenia-spectrum disorders. However, the best mode of implementation in terms of efficacy, service user and team preference and cost-effectiveness is still unclear. The CIRCuiTS Trial will provide guidance for large-scale roll-out of CRT to mental health services where cognitive difficulties impact recovery and resilience

Fitting parameters of the model for different currency pairs and years.

<p>Fitting parameters of the model for different currency pairs and years.</p

Sleep Disturbance in Individuals at Clinical High Risk for Psychosis.

IntroductionDisturbed sleep is a common feature of psychotic disorders that is also present in the clinical high risk (CHR) state. Evidence suggests a potential role of sleep disturbance in symptom progression, yet the interrelationship between sleep and CHR symptoms remains to be determined. To address this knowledge gap, we examined the association between disturbed sleep and CHR symptoms over time.MethodsData were obtained from the North American Prodrome Longitudinal Study (NAPLS)-3 consortium, including 688 CHR individuals and 94 controls (mean age 18.25, 46% female) for whom sleep was tracked prospectively for 8 months. We used Cox regression analyses to investigate whether sleep disturbances predicted conversion to psychosis up to &gt;2 years later. With regressions and cross-lagged panel models, we analyzed longitudinal and bidirectional associations between sleep (the Pittsburgh Sleep Quality Index in conjunction with additional sleep items) and CHR symptoms. We also investigated the independent contribution of individual sleep characteristics on CHR symptom domains separately and explored whether cognitive impairments, stress, depression, and psychotropic medication affected the associations.ResultsDisturbed sleep at baseline did not predict conversion to psychosis. However, sleep disturbance was strongly correlated with heightened CHR symptoms over time. Depression accounted for half of the association between sleep and symptoms. Importantly, sleep was a significant predictor of CHR symptoms but not vice versa, although bidirectional effect sizes were similar.DiscussionThe critical role of sleep disturbance in CHR symptom changes suggests that sleep may be a promising intervention target to moderate outcome in the CHR state